Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-26T13:15:05.563Z Has data issue: false hasContentIssue false

Care management and care provision for older relatives amongst employed informal care-givers

Published online by Cambridge University Press:  29 August 2007

CAROLYN J. ROSENTHAL*
Affiliation:
Centre for Gerontological Studies, McMaster University, Hamilton, Ontario, Canada.
ANNE MARTIN-MATTHEWS
Affiliation:
School of Social Work and Family Studies, University of British Columbia, Vancouver, Canada.
JANICE M. KEEFE
Affiliation:
Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
*
Address for correspondence: Carolyn Rosenthal, Centre for Gerontological Studies, McMaster UniversityKTH 226, Hamilton, Ontario L8S 4K1, Canada. E-mail: crosent@mcmaster.ca

Abstract

This paper examines care management, or ‘managerial care’, a type of informal care for older adults that has been relatively neglected by researchers. While previous research has acknowledged that care-giving may involve tasks other than direct ‘hands-on’ care, the conceptualisation of managerial care has often been vague and inconsistent. This study is the first explicitly to investigate managerial care amongst a large sample of carers. In our conceptualisation, care management includes care-related discussions with other family members or the care recipient about the arrangements for formal services and financial matters, doing relevant paperwork, and seeking information. The study examines the prevalence of this type of care, the circumstances under which it occurs, its variations by care-giver characteristics, and its impact on the carers. We drew from the Canadian CARNET ‘Work and Family Survey’ a sub-sample of 1,847 full-time employed individuals who were assisting older relatives. The analysis shows that managerial care is common, distinct from other types of care, a meaningful construct, and that most care-givers provide both managerial and direct care. Care management includes both the orchestration of care and financial and bureaucratic management. Providing managerial care generates stress amongst women and interferes with work amongst men, and the aspect that generates the greatest personal and job costs amongst both men and women is the orchestration of care.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aneshensel, C., Pearlin, L., Mullan, J., Zarit, S. and Whitlatch, C. 1995. Profiles in Caregiving: The Unexpected Career. Academic, San Diego, California.Google Scholar
Archbold, P. G. 1983. Impact of parent-caring on women. Family Relations, 32, 1, 3945.CrossRefGoogle Scholar
Bookwala, J., Yee, J. and Schulz, R. 2000. Caregiving and detrimental mental and physical health outcomes. In Williamson, G., Parmelee, P. and Shaffer, D. (eds), Physical Illness and Depression in Older Adults: A Handbook of Theory, Research, and Practice. Plenum, New York, 93131.Google Scholar
Brody, E. 2004. Women in the Middle: Their Parent-Care Years, Second Edition. Springer Publishing Company, New York.Google Scholar
Campbell, L. D. and Martin-Matthews, A. 2000. Caring sons: exploring men's involvement in filial care. Canadian Journal on Aging, 19, 1, 57–9.Google Scholar
Chappell, N. L. 1992. Social Support and Aging. Butterworths, Toronto, Ontario.Google Scholar
Chappell, N. L. and Blandford, A. 1991. Informal and formal care: exploring the complementarity. Ageing & Society, 11, 3, 299315.Google Scholar
Cohen, S. and Williamson, G. 1988. Perceived stress in a probability sample of the United States. In Spacapan, S. and Oskamp, S. (eds), The Social Psychology of Health. Sage, Newbury Park, California, 361–82.Google Scholar
Connidis, I., Rosenthal, C. J. and McMullin, J. 1996. The impact of family composition on providing help to older parents: a study of employed adults. Research on Aging, 18, 4, 402–19.Google Scholar
Daatland, S. O. and Herlofson, K. 2001. Service systems and family care: substitution or complementarity? In Daatland, S. O. and Katharina Herlofson, K. (eds), Ageing, Intergenerational Relations, Care Systems and Quality of Life: An Introduction to the OASIS Project. NOVA report 14/01, NOVA, Oslo, 5361.Google Scholar
Denton, M. 1997. The linkages between informal and formal care of the elderly. Canadian Journal on Aging, 16, 1, 3050.Google Scholar
Dwyer, J. and Seccombe, K. 1991. Elder care as family labor, the influence of gender and family position. Journal of Family Issues, 12, 2, 229–47.Google Scholar
Fast, J., Keating, N., Otfinowski, P. and Derksen, L. 2001. Characteristics of family/friend care networks of frail seniors. Canadian Journal on Aging, 23, 1, 519.CrossRefGoogle Scholar
Finley, N. J. 1989. Theories of family labor as applied to gender differences in caregiving for elderly parents. Journal of Marriage and the Family, 51, 1, 7986.CrossRefGoogle Scholar
Fischer, L. R. and Eustis, N. 1988. DRGs and family care for the elderly: a case study. The Gerontologist, 28, 3, 383–9.Google Scholar
Fredriksen, K. I. 1996. Gender differences in employment and the informal care of adults. Journal of Women and Aging, 8, 2, 3553.Google Scholar
Gottlieb, B. H., Kelloway, K. and Fraboni, M. 1994. Aspects of eldercare that place employees at risk. The Gerontologist, 34, 6, 815–21.CrossRefGoogle ScholarPubMed
Gutek, B. A., Searle, S. and Klepa, L. 1991. Rational versus gender role explanations for work-family conflict. Journal of Applied Psychology, 76, 4, 560–8.CrossRefGoogle Scholar
Horowitz, A. 1985. Sons and daughters as caregivers to older parents: differences in role performances and consequences. The Gerontologist, 25, 6, 612–16.CrossRefGoogle ScholarPubMed
James, N. 1992. Care=organisation+physical labour+emotional labour. Sociology of Health and Illness, 14, 4, 488509.CrossRefGoogle Scholar
Keating, N., Fast, J., Frederick, J., Cranswick, K. and Perrier, C. 1999. Eldercare in Canada: Context, Content and Consequences. Catalogue 89-570-XPE, Statistics Canada, Ottawa.Google Scholar
Lawrence, J. A., Goodnow, J. J., Woods, K. and Karantzas, G. 2002. Distributions of caregiving tasks among family members: the place of gender and availability. Journal of Family Psychology, 16, 4, 493509.CrossRefGoogle ScholarPubMed
Lingsom, S. 1997. The Substitution Issue: Care Policies and Their Consequences for Family Care. NOVA Report 6, NOVA, Oslo.Google Scholar
Martin-Matthews, A. and Rosenthal, C. J. 1993. Balancing work and family in an aging society: the Canadian experience. In Maddox, G. L. and Lawton, M. P. (eds), Annual Review of Gerontology and Geriatrics 13. Springer Publishing Company, New York, 96119.Google Scholar
Martin-Matthews, A. and Campbell, L. 1995. Gender roles, employment and informal care. In Arber, S. and Ginn, J. (eds), Connecting Gender and Ageing. Open University Press, Buckingham, 129–43.Google Scholar
Neal, M. B., Chapman, N. J., Ingersoll-Dayton, B. and Emlen, A. C. 1993. Balancing Work and Caregiving for Children, Adults and Elders. Sage, Newbury Park, California.Google Scholar
Neal, M. B., Ingersoll-Dayton, B. and Starrels, M. E. 1997. Gender and relationship differences in caregiving patterns and consequences among employed caregivers. The Gerontologist, 37, 6, 804–16.CrossRefGoogle ScholarPubMed
Noelker, L. and Bass, D. 1989. Home care for elderly persons: linkages between formal and informal caregivers. Journal of Gerontology: Social Sciences, 44, 2, S6370.Google Scholar
O'Bryant, S. and Morgan, L. A. 1990. Recent widows' kin support and orientations to self-sufficiency. The Gerontologist, 30, 2, 391–8.Google Scholar
Pavalko, E. K. and Artis, J. E. 1997. Women's caregiving and paid work: causal relationships in late midlife. Journal of Gerontology: Social Sciences, 52B, 4, S170–9.Google Scholar
Peace, S. and Holland, C. 2001. Homely residential care: a contradiction in terms? Journal of Social Policy, 30, 3, 393410.CrossRefGoogle Scholar
Pineo, P. C. 1985. Revision of the Pineo-Porter-McRoberts socioeconomic classification of occupations for the 1981 census. QSEP Report 125, Department of Economics, McMaster University, Hamilton, Ontario.Google Scholar
Raschick, M. and Ingersoll-Dayton, B. 2004. The costs and rewards of caregiving among aging spouses and adult children. Family Relations, 53, 3, 317–25.Google Scholar
Rosenthal, C. J., Sulman, J. and Marshall, V. W. 1992. Problems experienced by families of long-stay patients. Canadian Journal on Aging, 11, 2, 169–83.Google Scholar
Scharlach, A. E. and Boyd, S. L. 1989. Caregiving and employment: results of an employee survey. The Gerontologist, 29, 3, 382–7.CrossRefGoogle ScholarPubMed
Scharlach, A. E., Sobel, E. L. and Roberts, E. L. 1991. Employment and caregiver strain: an integrative model. The Gerontologist, 31, 6, 778–87.CrossRefGoogle ScholarPubMed
Seltzer, M. M., Ivry, J. and Litchfield, L. C. 1987. Family members as case managers: partnership between the formal and informal support networks. The Gerontologist, 27, 6, 722–8.Google Scholar
Seltzer, M. M., Litchfield, K., Robins, L. and Mayer, J. B. 1992. Professional and family collaboration in case management: a hospital-based replication of a community-based study. Social Work in Health Care, 17, 1, 122.CrossRefGoogle ScholarPubMed
Shanas, E. and Sussman, M. (eds) 1977. Family, Bureaucracy, and the Elderly. Duke University Press, Durham, North Carolina.Google Scholar
Sims-Gould, J., Martin-Matthews, A. and Rosenthal, C. In press. Family caregiving, helping and the intersection of gender: social dynamics in the provision of care to older adults in Canada. In Martin-Matthews, A. and Phillips, J. (eds), Blurring the Boundaries: Ageing at the Intersection of Work and Home Life. Lawrence Erlbaum, Hillsdale, New Jersey.Google Scholar
Stoller, E. Palo. 1989. Formal services and informal helping: the myth of service substitution. Journal of Applied Gerontology, 8, 1, 3752.Google Scholar
Stoller, E. P. 1990. Males as helpers: the role of sons, relatives, and friends. The Gerontologist, 30, 2, 228–35.Google Scholar
Stoller, E. P., Forster, L. E. and Duniho, T. S. 1992. Systems of parent care within sibling networks. Research on Aging, 14, 1, 2849.Google Scholar
Stoller, E. P. and Pugliesi, K. L. 1989. Other roles of caregivers: competing responsibilities or supportive resources? Journal of Gerontology: Social Sciences, 44, 6, S231–8.CrossRefGoogle ScholarPubMed
Stommel, M., Given, B. A., Given, C. W. and Collins, C. 1995. The impact of the frequency of care activities on the division of labor between primary caregivers and other care providers. Research on Aging, 17, 4, 412–33.CrossRefGoogle Scholar
Zarit, S. and Pearlin, L. 1993. Family caregiving: integrating informal and formal systems for care. In Zarit, S., Pearlin, L. and Schaie, K. W. (eds), Caregiving Systems, Informal and Formal Helpers. Lawrence Erlbaum, Hillsdale, New Jersey, 303–14.Google Scholar